23 October2011 Rolling Back Malaria in Hormozgan
Mohammad Yaaghoob, a 45 year-old migrant from Khunduz, Afghanistan, knows what it’s like to be sick. His memory of the fever and aches and pains of when he contracted malaria 12 years ago is still painfully fresh. So when Abdol-Karim Noorzehi, 17, living on the vacant lot he and 10 other Afghan migrants call home came to him shivering in Bandar Abbas’ searing heat, Mohammad knew exactly what to do.
Despite being foreign nationals and clandestine workers, the Afghan population living in Iran – up to 3 million people according to some estimates – receives free primary health care from the Iranian national health system. Mohammad himself benefitted from this when he experienced malarial symptoms during one of his numerous trips into southern Iran in search of work to feed his six children across the border. Mohammad immediately signaled Abdol-Karim’s condition to urban health house 3 where he had received treatment over a decade ago.
Things have changed dramatically since Mohammad’s last visit to the health house. The medical staff immediately dispatched a mobile team to test Abdol-Karim with a Rapid Diagnostic Test (RDT) procured by UNDP with the Global Fund grant on behalf of the CDC. RDTs yield a diagnosis in minutes - when Mohammad last visited the health house, patients were exclusively tested by blood sample, and diagnoses took a minimum of three days because of the distance between malaria labs in the province.
“Before the Global Fund project was rolled out, it could sometimes take up to five days to diagnose a patient because of the time it took for people to get to malaria labs and for processing blood samples,” explains Dr. Abolghasemi, Head of health laboratories in Hormozgan University of Medical Sciences.
Today the CDC, with financial backing by the Global Fund and support form UNDP, has supported set up 30 malaria labs across Hormozgan, Sistan & Baluchestan, and Kerman – three provinces in the south east of Iran which concentrate over 90% of malaria cases in the country.
Like many migrants from Afghanistan and Pakistan, Mohammad and Abdol-Karim contracted malaria in their home country, where malaria infection rates are significantly higher than in Iran. The new malaria labs created as part of the Global Fund project are concentrated in border areas to facilitate access by the country’s most at-risk population.
Now testing sites are more numerous and have been provided with high performance equipment, drastically reducing the time between the appearance of malarial symptoms, diagnosis and treatment.
Since the project was initiated three years ago, malaria infection rates have fallen nearly four-fold. At the project’s core are preventative measures like the systematic distribution of long-lasting insecticidal nets (LLINs), community education, insecticide spraying during the high risk periods of spring and late summer, and the creation of 10 emergency response sites.
Health care workers train community members like Mohammad to reduce their exposure to the disease. They receive LLINs, learn how to use and store them properly, and are taught what to do if malarial symptoms appear. These are vital skills, particularly for workers who travel frequently between Iran, Afghanistan and Pakistan.
“I make sure that we all sleep under the net. It’s especially important anytime we sleep outside or when the power is cut. It’s essential that we all stay healthy. We all work together here as garbage collectors and it becomes a problem for all of us if one of us gets sick: that person can’t work anymore and even needs someone to stay and look after him. None of us can afford it,” says Mohammad while demonstrating how he sets up the LLIN he and his companions received from a local health worker.
Thanks to the rapid detection tests kits the health house’s mobile team received with help from Global Fund, the center took minutes to confirm Abdol-Karim was infected with malaria. After an 8 week course of chloroquine and premaquine, and close monitoring by health staff for three weeks, he has fully recovered from an illness that could have cost him his life.
About the project
Under funding Round 7, the Islamic Republic of Iran received its first Global Fund malaria control grant in 2008, targeting the reduction of local malaria cases in Iran’s southeastern provinces of Hormozgan, Kerman and Sistan & Baluchestan. The Ministry of Health’s Malaria Control Department manages the US$ 10 million grant jointly with UNDP with support from the WHO. A grant under Round 10, aimed at eliminating falciparum malaria in priority areas in Iran, is recently concluded and will be rolled out soon.